Systemic lupus erythematosus classification scheme: Difference between revisions

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*Complement deficiency syndromes
*Complement deficiency syndromes


==Diagnosis==
 
===Physical Examination===
====Skin====
=====Lupus Erythematosus Chronicus Disseminatus Superficialis=====
======Face======
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Image:Lupus erythematosus chronicus disseminatus superficialis11.jpg|Lupus erythematosus chronicus disseminatus superficialis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Lupus erythematosus chronicus disseminatus superficialis11.jpg|Lupus erythematosus chronicus disseminatus superficialis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>

Revision as of 19:08, 26 June 2017

Systemic lupus erythematosus Microchapters

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Overview

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Differentiating Systemic lupus erythematosus from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Kiran Singh, M.D. [3]

Overview

Lupus may be classified into several subtypes according to clinical features which include: systemic lupus erythematosus, cutaneous lupus erythematosus, drug-induced lupus, and neonatal lupus. Systemic lupus erythematosus (SLE) itself may be classified into several subtypes based on glomerulonephritis and dermatologic manifestation. SLE may be classified according to dermatologic manifestations into 4 subtypes: acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE), chronic cutaneous lupus erythematosus (CCLE), and intermittent cutaneous lupus erythematosus (ICLE). SLE may be classified according to glomerulonephritis into 6 subtypes: minimal mesangial lupus nephritis (class I), mesangial proliferative lupus nephritis (class II), focal lupus nephritis (class III), diffuse lupus nephritis (class IV), lupus membranous nephropathy (class V), and advanced sclerosing lupus nephritis (class VI).

Classification

Lupus may be classified into several subtypes according to clinical features which include:

  • Systemic lupus erythematosus (SLE)
  • Cutaneous lupus erythematosus (CLE)
  • Drug-induced lupus
  • Neonatal lupus

Based on this classification, SLE is a subtype of lupus that can be classified into different subclasses as well. CLE can be presented with or without systemic symptoms of the disease.

Systemic lupus erythematosus (SLE) may be classified into several subtypes based on glomerulonephritis and dermatologic manifestation.

SLE classification based on dermatologic manifestations

SLE may be classified according to dermatologic manifestations into 4 subtypes:

  • Acute cutaneous lupus erythematosus (ACLE)
  • Subacute cutaneous lupus erythematosus (SCLE)
  • Chronic cutaneous lupus erythematosus (CCLE)
  • Intermittent cutaneous lupus erythematosus (ICLE)
Subtypes Manifestation/subclass
Acute cutaneous lupus erythematosus (ACLE)
  • Localized ACLE (ie, malar rash, butterfly rash)
  • Generalized ACLE
  • Toxic epidermal necrolysis-like ACLE
Subacute cutaneous lupus erythematosus (SCLE)
  • Annular SCLE
  • Papulosquamous SCLE
  • Drug-induced SCLE
  • Neonatal lupus (dermatitis manifestations)
  • Less common subtypes:
    • Erythrodermic
    • Poikilodermatous
    • Erythema multiforme-like (Rowell syndrome)
    • Vesiculobullous annular SCLE
Chronic cutaneous lupus erythematosus (CCLE)
  • Discoid lupus erythematosus (DLE)
    • Localized DLE
    • Generalized DLE
    • Hypertrophic DLE
  • Lupus erythematosus tumidus (LE tumidus)
  • Lupus profundus (also known as lupus panniculitis)
  • Chilblain lupus erythematosus (chilblain LE)
  • Lichenoid cutaneous lupus erythematosus-lichen planus overlap syndrome (LE-LP overlap syndrome)
Intermittent cutaneous lupus erythematosus (ICLE)
  • A consistent histopathologic feature of ACLE, SCLE, and discoid lupus erythematosus

SLE classification based on glomerulonephritis

SLE may be classified according to glomerulonephritis into 6 subtypes:

  • Minimal mesangial lupus nephritis (class I)
  • Mesangial proliferative lupus nephritis (class II)
  • Focal lupus nephritis (class III)
  • Diffuse lupus nephritis (class IV)
  • Lupus membranous nephropathy (class V)
  • Advanced sclerosing lupus nephritis (class VI)
Subtype Manifestation
Minimal mesangial lupus nephritis (class I)
  • The earliest and mildest form of glomerular involvement
  • Normal urinalysis, no or minimal proteinuria, and a normal serum creatinine
Mesangial proliferative lupus nephritis (class II)
  • Microscopic hematuria and/or proteinuria
Focal lupus nephritis (class III)
  • Hematuria and proteinuria
  • May also have hypertension, a decreased glomerular filtration rate, and/or nephrotic syndrome
Diffuse lupus nephritis (class IV)
  • Most common and most severe form
  • Hematuria and proteinuria
  • Nephrotic syndrome, hypertension, and reduced glomerular filtration rate
  • Hypocomplementemia (especially C3) and elevated anti-DNA levels, especially during active disease 7231154
Lupus membranous nephropathy (class V) 
  • Hematuria and proteinuria
  • Nephrotic syndrome, hypertension, and reduced glomerular filtration rate
  • Hypocomplementemia
Advanced sclerosing lupus nephritis (class VI)
  • Slowly progressive renal dysfunction
  • Proteinuria
    • Chilblain lupus erythematosus (Hutchinson)
    • Lupus erythematosus-lichen planus overlap syndrome
    • Lupus erythematosus panniculitis (Lupus erythematosus profundus)
    • Subacute cutaneous lupus erythematosus, which causes nonscarring skin lesions on patches of skin exposed to sunlight.[1]
    • Tumid lupus erythematosus
    • Verrucous lupus erythematosus (Hypertrophic lupus erythematosus)
  • Neonatal lupus erythematosus, a rare disease affecting babies born to women with SLE, Sjögren's syndrome, or sometimes no autoimmune disorder. It is theorized that maternal antibodies attack the fetus, causing skin rash; liver problems; low blood counts, which gradually fade; and heart block, leading to bradycardia.[1]
  • Childhood systemic lupus erythematosus, the pediatric variant of systemic lupus erythematosus.
  • Drug-induced lupus erythematosus, a drug-induced form of SLE; this type of lupus can occur equally in either gender.
  • Lupus nephritis, an inflammation of the kidneys caused by SLE
  • Complement deficiency syndromes


Trunk
Extremity
Lupus Erythematosus Chronicus Verrrucous
Extremity


Trunk
Lupus Erythematosus Profundus
Extremity
Subacute Cutaneous Lupus Erythematosus
Face
Head
Trunk
Systemic Lupus Erythematosus
Face

References

  1. ↑ 1.0 1.1 "Handout on Health: Systemic Lupus Erythematosus". The National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health. 2003. Retrieved 2007-11-23. Unknown parameter |month= ignored (help)
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 "Dermatology Atlas".

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